With an Eye Toward Equity, HP+ Assesses Madagascar's Financing System
To inform decision making toward future health financing reforms in Madagascar, with the ultimate vision of achieving national universal health coverage (UHC), HP+ assessed Madagascar’s current health financing arrangements. Findings from the assessment (currently available in French) suggest that Madagascar has a low revenue base, and the health sector relies heavily on donors and out-of-pocket payments to fund key programs and health facility costs. Given the country’s limited resource base, opportunities exist to increase efficiency in budgetary allocation and execution. With Madagascar’s commitment to UHC and its piloting of the National Health Solidarity Fund, this landmark assessment comes at a critical time to inform policies for reaching more of the population with an essential package of high-quality health services, financed to maximize financial protection for the poor and vulnerable.
The health sector relies heavily on external and out-of-pocket resources and has limited capacity to increase domestic resources for health Le secteur de la santé dépend fortement de ressources externes et des paiements direct des ménages et a une capacité limitée d'augmenter les ressources intérieures pour la santé
Health service quality and use is low, access is challenging and there is inequity in the distribution of human resources for health La qualité et l'utilisation des services de santé sont faibles, l'accès est difficile et la répartition des ressources humaines pour la santé est inéquitable
Employment-based and community-based health insurance mechanisms are limited, fragmented, and offer different benefit packages Les mécanismes d'assurance maladie basés sur l’emploi et les mutuelles de santé communautaire sont limités, fragmentés et offrent des paniers de soins différents
There is strong political will for a new health financing mechanism that targets the poor and informal sector Il existe une forte volonté politique pour un nouveau mécanisme de financement de la santé ciblant les pauvres et le secteur informel
There are opportunities to improve financial management systems to ensure effective budget execution Il existe des opportunités pour améliorer les systèmes de gestion financière pour assurer l'exécution efficace du budget
There are existing and pilot health financing mechanisms to increase financial protection for the poor Il existe des mécanismes de financement de la santé opérationnel dont certains en phase pilote qui augmentent la protection financière des pauvres
